CHILDHOOD BLEPHAROPTOSIS: A REVIEW OF 113 CASES

The aim of this study is to describe the etiology, clinical patterns, surgical management and outcome of a series of 113 pediatric ptosis patients. Methods. To determine the visual and cosmetic outcome following surgical correction of con- genital ptosis we reviewed the charts of 113 patients observed in our Department between January 2001 and December 2005. All patients undergo pre-op complete ophthalmological check, visual acuity, ocular motility imbalance, levator fuction and height of the palpebral fissure. Regarding the surgical procedure levator resection was performed in patients with a good function of the levator; a frontalis sospension was performed in patients with a poor levator function. results. 93 cases (82%) were unilateral, 20 (18%) bilateral; 21 patients (18%) had family history of ptosis. The etiology was myogenic in 74%, neurogenic in 11%, the jaw- wink ptosis was observed in 7%, aponeurotic in 4,5% and blepharophimosis in 3,5%. Regarding the eighths palpebral fissure, 34 cases (30%) presented severe ptosis, 63 cases (56%) moderate, 16 cases (14%) mild. Regarding the levator function 25 cases ( 22%) presented poor function or levator, 46 cases ( 41%) moderate, 42 cases ( 37%) good. Levator resection was performed in 77 cases (68%), frontalis suspension in 36 cases (32%). The postop- erative outcome was poor in 15 cases (13%), suboptimal 12 cases (11%) and good in 86 cases (76%). The incidence of am- bylopia was 25%. Conclusion. If a careful preoperative evaluation is performed, the surgical outcome in childhood can offer a very good prognosis.